NPI | 1356784573 |
---|---|
Former Name | JENNIFER ELIZABETH LIGHT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD457969) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD D97054) |
Enumeration Date | 2013-04-08 |
Last Update Date | 2023-08-14 |